Review of Pharmacology - 9E (2015)

Cardiovascular System
43. Ans. (d) Hypertrophic obstructive cardiomyopathy (Ref: KDT 6/e p500-502)
44. Ans. (a) Lisinopril (Ref: KDT 6/e p486)
45. Ans. (a) Adrenaline (Ref: KDT 6/e p493,503-504)
46. Ans. (d) Hyperkalemia (Ref: KDT 6/e p499)
47. Ans. (b) 0.8-1.5 ng/ml (Ref: KDT 6/e p497)
Digitoxin
Digoxin
– Therapeutic plasma conc. 15-30 ng/ml 0.5-1.4 ng/ml
– Toxic plasma conc. > 35 ng/ml > 2.5 ng/ml
48. Ans. (c) Treat digitalis toxicity (Ref: KDT 6/e p499)
49. Ans. (c) It is 95% plasma protein bound (Ref: KDT 6/e p497)
Plasma protein binding of digitoxin is high (95%) whereas it is low (70-80%) for digoxin.
50. Ans. (b) Propanolol (Ref: KDT 6/e p504)
Afterload is reduced by the drugs having arteriolar dilating property. Propanolol is a non-selective b-blocker. It can cause
vasoconstriction by antagonizing b 2
mediated vasodilatation. It, therefore do not decrease afterload.
51. Ans. (a) Guanylate cyclase (Ref: KDT 6/e p548-549)
Nitroprusside generates NO that relaxes vascular smooth muscles by activating guanylate cyclase.
52. Ans. (d) Na + K + ATPase (Ref: KDT 6/e p496)
53. Ans. (c) 5 day (Ref: KDT 6/e p497)
54. Ans. (a) Hydralazine (Ref: KDT 6/e p547)
55. Ans. (d) All of the above (Ref: KDT 6/e p498)
56. Ans. (b) Morphine (Ref: KDT 6/e p461)
57. Ans. (a) Na + K + ATPase pump (Ref: KDT 6/e p496)
58. Ans. (b) Captopril (Ref: Katzung 11/e p219)
59. Ans. (c) An increase in systolic intracellular calcium levels (Ref: Katzung 11/e p214)
60. Ans. (d) Fab fragments of digitalis antibodies (Ref: KDT 6/e p499)
61. Ans. (c) NPAT with block (Ref: KDT 6/e p498)
62. Ans. (c) Sodium nitroprusside (Ref: KDT 7/e p567-568)
Increase in systemic vascular resistance means vasoconstriction, thus a vasodilator drug like nitroprusside should be used.
Adrenaline and nor-adrenaline act as vasopressors whereas isoprenaline increases systolic blood pressure by acting on
heart.
63. Ans. (a) Propanolol (Ref: Katzung 10/e p165, 169; KDT 6/e p137)
• Methyldopa is useful in the treatment of mild to moderately severe hypertension. It lowers blood pressure chiefly by
reducing peripheral vascular resistance, with a variable reduction in heart rate and cardiac output.
• Prazosin and nitroprusside are vasodilators and produce reflex tachycardia instead of causing bradycardia.
• Propanolol is a non selective beta blocker and acts mainly by decreasing heart rate.
64. Ans. (a) Atenolol (Ref: KDT 6/e p139), Current hypertensive research May 2012; Antihypertensive treatment and sexual dysfunction.
• Diuretics have maximum risk of causing sexual dysfunction followed by beta blockers.
• Atenolol, metoprolol and carvedilol have high risk whereas nevibolol has minimum risk of erectile dysfunction.
• ACE inhibitors decrease the risk.
65. Ans. (b) It can cause severe hypoglycemia (Ref: Katzung 11/e p180)
Diazoxide cause hyperglycemia and not hypoglycemia
General Cardiovascular Pharmacology System
• Diazoxide is an effective and relatively long-acting parenterally administered arteriolar dilator that is occasionally
used to treat hypertensive emergencies.
• It acts by opening ATP sensitive potassium channels.
• The most significant toxicity from diazoxide has been excessive hypotension.
• Diazoxide inhibits insulin release from the pancreas (probably by opening potassium channels in the cell
membrane) and is used to treat hypoglycemia secondary to insulinoma.
• Occasionally, hyperglycemia complicates diazoxide use, particularly in persons with renal insufficiency.
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